Provider Demographics
NPI:1699928200
Name:WANG, SHIIYUH HUANG (MD)
Entity type:Individual
Prefix:DR
First Name:SHIIYUH
Middle Name:HUANG
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3140
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:4144 N CENTRAL EXPY
Practice Address - Street 2:SUITE 360
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3140
Practice Address - Country:US
Practice Address - Phone:214-827-7460
Practice Address - Fax:214-826-6858
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232303390200000X
TXN5470207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214081609Medicaid
TX8EH628OtherBCBS
TXP01446843OtherRR
TXP01446843OtherRR
TXTXB107236Medicare PIN
TX214081601Medicaid
TX214081606OtherMEDICAID CSHCN
TXTXB107239Medicare PIN
TX214081608OtherMEDICAID CSHCN
TX8CK449OtherBCBS